Samantha J Sabala, LCSW, CCM

Primary specialty

Social WorkerTaxonomy code 104100000X

License

LCSW76308 Issued in CA

Practice address

9229 Regents Rd Unit L106
La Jolla, CA 92037-9192

Phone

(916) 208-8213

NPI assigned

Jul 9, 2020

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1594252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602028800000",
    "number": "1649898347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9229 REGENTS RD UNIT L106",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920379192",
            "telephone_number": "916-208-8213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9229 REGENTS RD UNIT L106",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920379192",
            "telephone_number": "916-208-8213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SABALA",
        "first_name": "SAMANTHA",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "LCSW, CCM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-09",
        "last_updated": "2020-10-07",
        "certification_date": "2020-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "LCSW76308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": ".",
            "affiliation": "N",
            "address_1": "88 Coloma Way",
            "city": "Sacramento",
            "state": "CA",
            "country_code": "US",
            "postal_code": "958192246",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sean Michael Ryan, M.D.
• S&I Capital LLC
• John J. Saad, M.D.
• Saade Terranova Dental Partnership
• Jesus Sabala
• Sabina R Wallach MD AMC
• Sabina R. Wallach, M.D. a Medical Corp
• David Allen Sabourin, DDS
• Sabrina Valdez Licsw
• Peter V. Sacks, M.D.

• Social Worker in La Jolla, CA
• Providers in La Jolla, CA by specialty
• Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.